Prevalence and Characterization of Coagulase Positive Staphylococci from Food Products and Human Specimens in Egypt

Novel natural and economic approach for controlling methicillin-resistant Staphylococcus aureus using apple cider vinegar

Methicillin-resistant Staphylococcus aureus (MRSA) constitutes a significant health concern because it promotes infectious mastitis in dairy animals and poses a hazard risk to humans. Controlling MRSA infections is a growing challenge on a global scale because of the bacteria's toxicity and its capacity to develop multidrug resistance (MDR). Combating against MDR bacteria and the spread of infectious diseases needs natural antibacterial alternatives to minimize the economic losses of mastitis. The average treatment cost in Egypt was highlighted. The antibacterial effect of apple cider vinegar (ACV) against MDR-MRSA isolates was evaluated, also the study aimed at profiling antimicrobial resistance genes in MRSA isolates. The incidence of mastitis in cows was more than in buffaloes, and the average total treatment cost was estimated at 82 million EGP from 2016 to 2021 (around 14 million EGP annually). Of the 22 S. aureus isolates (20 %), of which (59.1 % were from cows and 40.9 % from buffaloes), 19 (86.4 %) were confirmed as MRSA. All MRSA isolates exhibited resistance to clindamycin (94.7 %), then both ampicillin and doxycycline (84.2 %), and ampicillin and sulbactam, erythromycin and Fosfomycin (each, 78.9 %). Vancomycin, ciprofloxacin, and levofloxacin can be used to treat MRSA. The prevalence of MDR was significantly high, with 94.7 % of the cases having multiple antimicrobial resistance (MAR) indices ranging from 0.25 to 0.75. All MRSA isolates tested positive for mecA, 89.5 % for the blaZ gene, 84.2 % for tetM, and 73.4 % for ermB. In vitro, the antibacterial properties of ACV were demonstrated to be superior by our results which demonstrate a zone of inhibition with diameters ranging from 20 to 40 mm detected by Agar well diffusion technique and MIC's (Minimal Inhibitory Concentration) ranging from 2 to 4 μg/ml. Some isolates possess MBC (Minimal Bactericidal Concentration) values at the same MIC. This research proposes the potential of ACV to act as a promising antibacterial alternative against MRSA. This can help minimize the health problem of antibiotic-resistant bacteria and improve the efficiency of dairy farms. Further studies are recommended to determine the proper dosage for field administration.

Prevalence Trends of Foodborne Pathogens Bacillus cereus, Non-STEC Escherichia coli and Staphylococcus aureus in Ready-to-Eat Foods Sourced from Restaurants, Cafés, Catering and Takeaway Food Premises

Foodborne pathogens of Bacillus cereus (B. cereus), non-STEC Escherichia coli (non-STEC E. coli) and Staphylococcus aureus (S. aureus) are currently non-notifiable in Australia unless attributed to a food poisoning outbreak. Due to the lack of data around individual cases and isolations in foods, any changes in prevalence may go undetected. The aim of this study was to determine any changes in the prevalence of B. cereus, non-STEC E. coli and S. aureus in ready-to-eat (RTE) foods sampled from Western Australian restaurants, cafés, catering facilities and takeaway food premises from July 2009 to June 2022. A total of 21,822 microbiological test results from 7329 food samples analysed over this 13-year period were reviewed and analysed. Linear trend graphs derived from the annual prevalence and binary logistic regression models were used to analyse the sample results, which indicated an increase in prevalence for B. cereus. In contrast, a decrease in prevalence for both S. aureus and non-STEC E. coli was determined. Additionally, there were changes in prevalence for the three bacteria in specific months, seasons, specific RTE foods and food premises types. Further research is needed to gain a better understanding of the potential drivers behind these changes in prevalence, including the potential impacts of climate change, COVID-19, legislation and guidelines targeting specific RTE foods, and the difficulty of differentiating B. cereus from B. thuringeniesis using standard testing methods.

"One Health" Perspective on Prevalence of ESKAPE Pathogens in Africa: A Systematic Review and Meta-Analysis

The leading cause of hospital-acquired infections worldwide includes Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp. (ESKAPE) infections. These bacteria are commonly isolated from clinical settings and linked to a number of potentially fatal diseases associated with hospitals. The objective of this study was to review the prevalence of ESKAPE pathogens in Africa. We gathered and systematically reviewed the literature concerning the prevalence of ESKAPE pathogens, published in the English language from January 2014 to February 2024, from three databases (PubMed, Web of Science and ScienceDirect). Our overall results revealed that S. aureus was the most prevalent species (79.5%), followed by A. baumannii (27.6%), K. pneumoniae (24.2%), Enterobacter spp. (20%), P. aeruginosa (9.0%), and E. faecium (5.1%). Moreover, stool samples had the highest Pooled Prevalence Estimates (PPEs) of 44.0%, followed by urine, nasal, and blood samples with 37.3%, 26.9%, and 22.9%, respectively. For the diagnostic method used to identify these ESKAPE pathogens, VITEK-MS had the highest PPE of 55.2%, followed by whole genome sequencing and PCR with 37.1% and 33.2%, respectively. The highest PPE of ESKAPE pathogens was recorded in West Africa with 77.3%, followed by Central/Middle Africa and East Africa with 43.5% and 25.1%, respectively. The overall PPE of ESKAPE pathogens from humans, animals, the environment (water, soil, and surfaces) and food sources was 35.8%, 37.3%, 47.7%, and 34.2%, respectively. Despite their prevalence in nosocomial settings, studies have shown that the ESKAPE pathogens may be isolated from a range of environmental reservoirs, including soil, dumping sites, beach sand, wastewater, food, and fish farms, among others. This wide source of ESKAPE pathogens substrates indicates the need for a multidisciplinary collaborative partnership for epidemiological studies and intervention efforts by the human, veterinary, and environmental health sectors in Africa.

Phenotypic and genotypic characterization of methicillin resistant Staphylococcus aureus associated with pyogenic infections

Background and Objectives

Staphylococcal infections are one of the major infectious diseases affecting globally in spite of advances in development of antimicrobial agents. Knowledge and awareness about the local pattern and prevalence of MRSA infections plays a key role in treatment. The aim of this study was to identify MRSA strains by phenotypic and genotypic methods and to analyze the antibiotic susceptibility pattern of MRSA strains from patients attending a tertiary care hospital.

Materials and Methods

This study was conducted over a period of 1 year, where 296 isolates of Staphylococcus aureus were isolated from various clinical specimens. The isolated strains were examined for antibiotic susceptibility by the modified Kirby Bauer disc diffusion method. Methicillin resistance was detected by cefoxitin disk diffusion test.

Results

A total of 104 isolates were found to be MRSA and 192 were found to be MSSA. Among the 104 MRSA isolates, 10 strains that were multidrug resistant were subjected to 16S rRNA gene sequencing analysis. All the 10 strains had a 99% match with S. aureus strains that were responsible for causing some serious biofilm mediated clinical manifestations like cystic fibrosis and device mediated infections. The biofilms were quantified using crystal violet staining and their ability to produce biofilms was analyzed using scanning electron microscopy and matched with the Genbank.

Conclusion

Hence these phylogenetic analysis aid in treating the patients and combating resistance to antibiotics.

Methicillin-Resistant Staphylococcus aureus (MRSA) in Dairy Products and Bulk-Tank Milk (BTM)

In order to contribute to an assessment of the role of food in the risks of transmission of methicillin-resistant Staphylococcus aureus (MRSA), a review was undertaken of research on this microorganism in milk and dairy products published from January 2001 to February 2024. A total of 186 publications were selected, 125 for dairy products and 61 for bulk-tank milk (BTM). MRSA was detected in 68.8% of the research into dairy products and 73.8% of investigations relating to BTM, although in most studies the prevalence was less than 5%. Of the set of S. aureus strains isolated, approximately 30% corresponded to MRSA. The foods most extensively contaminated with this microorganism were raw milk and some types of soft cheese. Determination of the mecA gene on its own is known not to suffice for the detection of all MRSA strains. The great diversity of techniques used to study MRSA in milk and dairy products made it difficult to draw comparisons between studies. It would thus be advisable to develop a standardized protocol for the study of this microorganism in foods.

Contribution of Food to the Human Health Burden of Antimicrobial Resistance

The impact of foodborne antimicrobial resistance (AMR) on the human health burden of AMR infections is unknown. The aim of this review was to evaluate and summarize the scientific literature investigating all potential sources of human AMR infections related to food. A literature search was conducted in Embase (Ovid) and MEDLINE (Ovid) databases to identify appropriate studies published between 2010 and 2023. The results of the search were reviewed and categorized based on the primary subject matter. Key concepts from each category are described from the perspective of food safety as a public health objective. The search yielded 3457 references, 1921 remained after removal of duplicates, abstracts, editorials, comments, notes, retractions, and errata. No properly designed source attribution studies were identified, but 383 journal articles were considered relevant and were classified into eight subcategories and discussed in the context of four streams of evidence: prevalence data, epidemiological studies, outbreak investigations and human health impact estimates. There was sufficient evidence to conclude that AMR genes, whether present in pathogenic or nonpathogenic bacteria, constitute a foodborne hazard. The level of consumer risk owing to this hazard cannot be accurately estimated based on the data summarized here. Key gaps in the literature are noted.

Methicillin-resistant coagulase-positive staphylococci in new, middle-aged, and old veterinary hospitals in southern Thailand: A preliminary study

Background and Aim

Methicillin-resistant coagulase-positive staphylococci (MRCoPS) cause pyoderma, dermatitis, and nosocomial infection. Numerous factors, including indiscriminate antimicrobial use (AMU) in veterinary medicine, cleaning practices, and AMU in hospitals, contribute to MRCoPS. However, the relationship between hospital age and MRCoPS has not yet been investigated. This study aimed to estimate the prevalence of MRCoPS in the treatment and operation rooms of new, middle-aged, and old veterinary hospitals.

Materials and Methods

Samples were collected from small animal hospitals in Surat Thani, Nakhon Si Thammarat, and Songkhla in Thailand. Hospitals were defined as those that had been in operation for 5 years (new, n = 5), 5-15 years (middle-aged, n = 6), or >15 years (old, n = 3). Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry was used to identify 280 samples, and duplex polymerase chain reaction was used to identify resistance genes (mecA and blaZ). The VITEK2® automated system was then used to determine the minimum inhibitory concentration.

Results

A total of 57 Staphylococcus species were identified and classified as coagulase-positive staphylococci (CoPS) (22/57, 38.60%) or coagulase-negative staphylococci (35/57, 61.40%), respectively. Nine of the 22 CoPS (40.90%) harbored the mecA gene, and 21 isolates (95.45%) harbored the blaZ gene. Interestingly, more MRCoPS was found in new hospitals (six isolates) than in middle-aged (one isolate) and old hospitals (two isolates), although there was no statistically significant difference in the presence of MRCoPS across new, middle-aged, and old veterinary hospitals (p = 0.095), Kruskal-Wallis test. There is a need for further detailed studies, including an increase in the number of hospitals in various locations.

Conclusion

MRCoPS is a nosocomial pathogen that causes zoonotic and recurrent infections in veterinary hospitals. The prevalence of MRCoPS tended to be higher in new hospitals. Areas with heavy animal contact, such as hospital floors, are areas of particular concern, and cleaning/disinfection of these areas must be highlighted in hygiene regimens.

Comparative meta-analysis of antimicrobial resistance from different food sources along with one health approach in the Egypt and UK

BACKGROUND

Antimicrobial resistance (AMR) is a critical global issue that poses significant threats to human health, animal welfare, and the environment. With the increasing emergence of resistant microorganisms, the effectiveness of current antimicrobial medicines against common infections is diminishing. This study aims to conduct a competitive meta-analysis of surveillance data on resistant microorganisms and their antimicrobial resistance patterns in two countries, Egypt and the United Kingdom (UK).

METHODS

Data for this study were obtained from published reports spanning the period from 2013 to 2022. In Egypt and the UK, a total of 9,751 and 10,602 food samples were analyzed, respectively. Among these samples, 3,205 (32.87%) in Egypt and 4,447 (41.94%) in the UK were found to contain AMR bacteria.

RESULTS

In Egypt, the predominant resistance was observed against β-lactam and aminoglycosides, while in the United Kingdom, most isolates exhibited resistance to tetracycline and β-lactam. The findings from the analysis underscore the increasing prevalence of AMR in certain microorganisms, raising concerns about the development of multidrug resistance.

CONCLUSION

This meta-analysis sheds light on the escalating AMR problem associated with certain microorganisms that pose a higher risk of multidrug resistance development. The significance of implementing One Health AMR surveillance is emphasized to bridge knowledge gaps and facilitate accurate AMR risk assessments, ensuring consumer safety. Urgent actions are needed on a global scale to combat AMR and preserve the effectiveness of antimicrobial treatments for the well-being of all living beings.

Future scope of plant-derived bioactive compounds in the management of methicillin-resistant Staphylococcus aureus: In vitro antimicrobial and antivirulence prospects to combat MRSA

Methicillin-resistant Staphylococcus aureus (MRSA) is a foremost human and animal pathogen with public health and veterinary significance causing hospital and community infections and contagious bovine mastitis. Due to its ability to develop multidrug resistance (MDR) and its pathogenicity, MRSA infection control is becoming a global concern. Natural antibacterial options are needed to combat MDR development and infectious dissemination. This study investigated the antimicrobial resistance and virulence genes profiling of MRSA isolates and explored the antivirulence efficacy of trans-cinnamaldehyde, thymol, and carvacrol essential oils (EOs) against multivirulent and MDR-MRSA isolates. Thirty six S. aureus isolates (25%) were retrieved, of which 34 (94.4%) were MRSA. A high prevalence of MDR (66.7%) was monitored and all 53 molecularly verified isolates possessed icaA and cna virulence genes. Moreover, 94.1% of these isolates were multivirulent with 23.5% of them carrying icaA, cna, eta, tst, and sea virulence genes. Our data proved superior in vitro antimicrobial and antivirulence activities of trans-cinnamaldehyde, thymol, and carvacrol. They inhibited the growth of multi-virulent and MDR-MRSA isolates and downregulated the transcription of examined virulence genes. Our study suggests using EOs as prospective antimicrobials with excellent antivirulence activities against MRSA isolates. We provided data regarding the eventual role of phytogenics in prevention and control of MRSA infection.

The Characterization and Beta-Lactam Resistance of Staphylococcal Community Recovered from Raw Bovine Milk

Staphylococci is an opportunistic bacterial population that is permanent in the normal flora of milk and poses a serious threat to animal and human health with some virulence factors and antibiotic-resistance genes. This study was aimed at identifying staphylococcal species isolated from raw milk and to determine hemolysis, biofilm, coagulase activities, and beta-lactam resistance. The raw milk samples were collected from the Düzce (Türkiye) region, and the study data represent a first for this region. The characterization of the bacteria was performed with MALDI-TOF MS and 16S rRNA sequence analysis. The presence of coa, icaB, blaZ, and mecA was investigated with PCR. A nitrocefin chromogenic assay was used for beta-lactamase screening. In this context, 84 staphylococci were isolated from 10 different species, and the dominant species was determined as S. aureus (32.14%). Although 32.14% of all staphylococci were positive for beta hemolysis, the icaB gene was found in 57.14%, coa in 46.42%, mecA in 15.47%, and blaZ in 8.33%. As a result, Staphylococcus spp. strains that were isolated from raw milk in this study contained some virulence factors at a high level, but also contained a relatively low level of beta-lactam resistance genes. However, considering the animal–environment–human interaction, it is considered that the current situation must be monitored constantly in terms of resistance concerns. It must not be forgotten that the development of resistance is in constant change among bacteria.

Laboratory Diagnostic Methods and Antibiotic Resistance Patterns of Staphylococcus aureus and Escherichia coli Strains: An Evolving Human Health Challenge

Raw ground meat is known as a transmission vehicle for biological agents that may be harmful to human health. The objective of the present study was to assess microbiological quality of the ground meats. A total of 280 samples of local and imported chilled meats were randomly collected from retail shops in Buraydah City, Saudi Arabia. The meat samples were microbiologically analyzed using standard methods, peptide mass fingerprinting (PMF) technique, MicroScan Walkaway System (MicroScan) and qPCR System. The imported meat was more bacterially contaminated than local meat, with variable contamination degrees of Staphylococcus aureus (40.33%), Escherichia coli (36.13%), Hafnia alvei (7.56%), Pseudomonas spp. (6.72%), Salmonella spp. (5.88%) and Aeromonas spp. (3.36%). PMF verified all the isolated bacteria by 100%, compared to 75-95% achieved by MicroScan. The gene encoding flagellin (fliC) was recognized in 67.44% of E. coli strains, while the thermonuclease (nuc) and methicillin resistance (mecA) genes were detected in 100% S. aureus and 39.6% of methicillin-resistant S. aureus (MRSA) strains, respectively. The S. aureus and E. coli strains were highly resistant to multiple antibiotics (e.g., ampicillin, amoxicillin-clavulanic acid and cephalothin). For identifying various foodborne pathogens, PMF has been recognized as a powerful and precise analytical method. In light of the increasing use of PMF to detect multidrug-resistant bacteria, this study emphasizes the need for improved ways of treating and preventing pathogens, as well as setting up monitoring systems to guarantee hygiene and safety in meat production.

Comparative Genotypic Analysis of RAPD and RFLP Markers for Molecular Variation Detection of Methicillin-Resistant Staphylococcus aureus Clinical Isolates

Background and Objectives: Methicillin-resistant Staphylococcus aureus (MRSA) isolates are associated with various diseases ranged from mild superficial impairments to invasive infections. This study aimed to evaluate the ability of polymerase chain reaction (PCR) based methods namely, restriction fragment length polymorphism (RFLP) of the coa gene and random amplified polymorphic DNA (RAPD), to determine the genetic diversity of MRSA isolates. Materials and Methods: A total of 37 MRSA isolates were conventionally identified depending on their biochemical and microbiological culture characteristics. Genotypic confirmation was based on detection of the associated mecA gene. The genetic variation amongst MRSA isolates was evaluated following the coa gene-based RFLP and RAPD fingerprints. Results: Results illustrated that, the species specific coa gene was detected in all MRSA isolates. The irregular bands intensity, number, and molecular sizes of the PCR amplicons demonstrated the coa gene polymorphism. The incompatible AluI digestion patterns of these amplicons classified the tested MRSA isolates into 20 RFLP patterns which confirm the coa gene polymorphism. Additionally, the PCR-based RAPD analysis showed variable bands number with size range of approximately 130 bp to 4 kbp, which indicated the genetic variation of the tested MRSA isolates as it created 36 variable RAPD banding profiles. Conclusions: coa gene AluI enzymatic restriction sites, amongst the tested MRSA isolates, certify their genetic variation on the basis of the accurate but complicated and relatively expensive coa gene-based RFLP. Conversely, the results verified the excellent ability of the simple and cost-effective PCR-based RAPD analysis to discriminate between MRSA isolates without any preface data about the genome.

Prevalence and Molecular Characterization of Mycoplasma Species, Pasteurella multocida, and Staphylococcus aureus Isolated from Calves with Respiratory Manifestations

Bovine respiratory disease (BRD) is a complex syndrome associated with high mortality in young calves and causes severe economic losses in the cattle industry worldwide. The current study investigated the prevalence and molecular characterization of common bacterial pathogens associated with respiratory symptoms in young calves from Sadat City, one of the largest industrial cities in Menoufiya Governorate, Egypt. In between December 2020 and March 2021, 200 mixed-breed young calves of 6–12 months were examined clinically. Of them, sixty (30%) calves showed signs of respiratory manifestations, such as coughing, serous to mucopurulent nasal discharges, fever, and abnormal lung sound. Deep nasal (Nasopharyngeal) swabs were collected from the affected calves for bacteriological investigation. Phenotypic characterization and identification revealed Mycoplasma bovis, Mycoplasma bovigenitalium, Pasteurella multocida, and Staphylococcus aureus in 8.33%, 5%, 5%, and 5% of the tested samples, respectively. The PCR technique using species-specific primer sets successfully amplified the target bacterial DNA in all culture-positive samples, confirming the identity of the isolated bacterial species. Partial gene sequencing of 16S rRNA gene of M. bovigenitalium, P. multocida, and S. aureus, and mb-mp 81 gene of M. bovis revealed high nucleotide similarity and genetic relationship with respective bacterial species reported from Egypt and around the world, suggesting transmission of these bacterial species between animal host species and localities. Our study highlights the four important bacterial strains associated with respiratory disorders in calves and suggests the possible spread of these bacterial pathogens across animal species and different geographic locations. Further studies using WGS and a large number of isolates are required to investigate the realistic lineage of Egyptian isolates and globally.

Prevalence, Enterotoxigenic Potential and Antimicrobial Resistance of Staphylococcus aureus and Methicillin-Resistant Staphylococcus aureus (MRSA) Isolated from Algerian Ready to Eat Foods

Staphylococcus aureus causes a foodborne intoxication due to the production of enterotoxins and shows antimicrobial resistance, as in the case of methicillin-resistant strains (MRSA). Herein, we analyzed 207 ready-to-eat foods collected in Algeria, reporting a S. aureus prevalence of 23.2% (48/207) and respective loads of coagulase positive staphylococci (CPS) ranging from 1.00 ± 0.5 to 5.11 ± 0.24 Log CFU/g. The 48 S. aureus isolates were widely characterized by staphylococcal enterotoxin gene (SEg)-typing and 16S-23S rDNA intergenic spacer region (ISR)-PCR, as well as by detecting tst and mecA genes, genetic determinants of toxic shock syndrome toxin-1 and methicillin resistance, respectively. We found that the S. aureus isolates belonged to seven different SEg-types harboring the following combinations of genes: (1) selW, selX; (2) egc (seG, seI, seM, seN, seO), selW, selX; (3) seA, seH, seK, seQ, selW, selX; (4) seB, selW, selX; (5) seD, selJ, seR, selW, selX; (6) seH, selW, selX, selY; and (7) seA, egc, selW, selX, while among these, 2.1% and 4.2% were tst- and mecA- (staphylococcal chromosomal cassette mec-type IV) positive, respectively. Selected strains belonging to the 12 detected ISR-types were resistant towards antimicrobials including benzylpenicillin, ofloxacin, erythromycin, lincomycin, tetracyclin, kanamycin, oxacillin, and cefoxitin; 8.3% (1/12) were confirmed as MRSA and 16.7% (2/12) were multidrug resistant. The present study shows the heterogeneity of the S. aureus population in Algerian ready-to-eat foods as for their toxigenic potential and antimicrobial resistance, shedding the light on the quality and safety related to the consume of ready-to-eat foods in Algeria.

Occurrence of Multidrug-Resistant Staphylococcus aureus among Humans, Rodents, Chickens, and Household Soils in Karatu, Northern Tanzania

We conducted this study to investigate the isolation frequency and phenotypic antibiotic resistance pattern of Staphylococcus aureus isolated from rodents, chickens, humans, and household soils. Specimens were plated onto mannitol salt agar (Oxoid, Basingstoke, UK) and incubated aerobically at 37 °C for 24 h. Presumptive colonies of S. aureus were subjected to Gram staining, as well as catalase, deoxyribonuclease (DNAse), and coagulase tests for identification. Antibiotic susceptibility testing was performed by using the Kirby-Bauer disc diffusion method on Mueller-Hinton agar (Oxoid, Basingstoke, UK). The antibiotics tested were tetracycline (30 μg), erythromycin (15 μg), gentamicin (10 μg), ciprofloxacin (5 μg), clindamycin (2 μg), and amoxicillin-clavulanate (20 μg/10 μg). The S. aureus strain American Type Culture Collection (ATCC) 25,923 was used as the standard organism. We found that 483 out of 956 (50.2%) samples were positive for S. aureus. The isolation frequencies varied significantly between samples sources, being 52.1%, 66.5%, 74.3%, and 24.5%, respectively, in chickens, humans, rodents, and soil samples (p < 0.001). S. aureus isolates had high resistance against clindamycin (51.0%), erythromycin (50.9%), and tetracycline (62.5%). The overall prevalence of multidrug-resistant (MDR) S. aureus isolates was 30.2%, with 8.7% resistant to at least four different classes of antibiotics.